| NPI | 1003076530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003890A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5793) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2015-08-17 |